DEPARTMENT OF VOCATIONAL HIGHER SECONDARY EDUCATION

Application for Issue of Duplicate Copy of Trade Certificate/Certificate (Marklist/Score Sheet)

Name & Address

PincodeE-mail Mobile Phone:

Name of Parent/GuardianDate of Birth

DD MM YYYY

Details of Lost/Damaged documents

Reg. No Month & Year Course Name of CentreTrade Certificate

Reg. No Month & Year Course Name of CentreCertificate (Score Sheet/Marklist)

Circumstances under which a duplicate certificate is requiredIf the original Certificate/Marklist is irrecoverably lost, whether declaration of the candidate attested by a I Class Judicial Magistrate under the seal of the Court/by the Commanding Officer in the case of Jawans/Embassy Officer authorised to sign, if the document is lost in foreign country, describing the circumstances under which it has irrecoverably lost submitted along with the application.

stst

If the original Certificate/Marklist is damaged whether details of damage furnished and remnantys of damaged Certificate/Marklist enclosed.

Whether the applicant had applied for a duplicate copy of the Certificate/Marklist earlier?

If YES, give details

Fee remittance details

Amount ` Chalan No: Date of remittance

Name of Treasury

DECLARATION

I ........................................................................................................................................................................ hereby declare that the facts stated above are true and correct and the original Certificate/Marklist will not be misused and that if it is recovered hereafter, it will be surrendered to the Secretary, Board of Vocational Higher Secondary Examinations, Kerala.

Place:Date:

Signature of the Applicant

CERTIFICATE

The details furnished by the applicant have been carefully verified with this office records and found correct and true. Also certified that the original certificate/marklist issued to the applicant is irrecoverably lost/damaged. Hence I recommended that a duplicate Vocational Higher Secondary Certificate/Marklist may be issued to the applicant.

Place:Date:

Signature of the Head of Institution

Name & Designation(Office Seal)Instructions

Application for duplicate copy of the Trade Certificate/Certificate (Score Sheet/Marklist) should be complete in all respects.In the case of lost documents an affidavit in the prescribed format typed in stamp paper worth not below `25/- and attested by a I Class Judicial Magistrate/Commanding Officer in the case of Jawans/Embassy Officer authorised to sign, if the document is lost in foreign country, to be furnished.Remnants of Marklist or Certificate if any in which details of candidate are available should be placed in cover and attached with application duly noting the same on the cover. in such cases affidavit is not required.The rate of fees for issue of duplicate Trade Certificate/Score Sheet/Marklist is `300/- each and `400/- for Triplicate Marklist/Score Sheet (Certificate)/Trade Certificate.The amount should be remitted into a Government Treasury in the name of the applicant under the Head of Account “0202-01-102-93 VHSE Fees” and the original chalan to be attached with the application.Application should be forwarded through the Head of the Institution.

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FORMAT OF AFFIDAVIT (for Duplicate Copy of Marklist/Certificate)I, ........................................................................................................................................................................

son/daughter of ............................................................................................................................................................

aged ............................................. years ......................................................................................................................

......................................................................................................................................................................................

................................................................................................................... (full address) do hereby affirm and states

as follows:

That I was a student in the ..........................................................................................................................

..................................................................................................................................................... (Name of

School with Place) for the Vocational Higher Secondary Course ...............................................................

.....................................................................................................................................................................

................................................... during the academic years ......................................................................

That I have appeared for the I Year/II Year Examination in ........................................................................

vide Register No: ............................................................. and passed in ...................................................

Class.

That the Vocational Higher Secondary Certificate/Marklist with eligibility certificate, Sl. No: .....................

Dated ............................... issued (Certificate), Sl. No: ................................... Dated ................................

issued (Marklist) by the Secretary, Board of Vocational Higher Secondary Examinations,

Thiruvananthapuram has been irrecoverably lost/damaged leaving no remnants of it due to ........................

.....................................................................................................................................................................

............................................................................................. (state circumstances).

That I have not misused the said Vocational Higher Secondary Certificate/Marklist for any purpose.

That I will not misuse the said Certificate/Marklist and nobody will be allowed to do so an,

That the Certificate/Marklist would be surrendered to the Secretary, Board of Vocational Higher Secondary

Examinations, Thiruvananthapuram if it is recovered hereafter.

All the facts state above are true and correct to the best of my knowledge and belief.

Place:

Date: Signature of Applicant

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